Medical Information Event Manager

ABSTRACT

An event management system and method detects the occurrence of events as a function, at least in part, of information and data gathered from monitoring one or more patients with a medical information system. Event detection processes can be defined and then triggered to cover any of a variety of circumstances. For instance, event detection processes can be defined that, when triggered, indicate that a certain patient (or patients) would make a suitable candidate for that clinical trial, a patient is a candidate for a certain type of treatment, or hospital resources are being utilized in a certain manner. That is, such events may relate to the efficiency or inefficiency in use of certain resources, or such events may concern usage under certain circumstances.

FIELD OF THE INVENTION

The inventive concepts relate to network computer systems and methods.More specifically, the present invention relates to systems and methodsfor creating, customizing and managing events relating to medical databy healthcare professionals.

BACKGROUND

When an individual is admitted as a patient into a hospital, certaininformation about the patient must be acquired and made available tovarious members of the hospital staff. Such information includes, forexample, the patient's identity, address, age and occupation, next ofkin, medical history, conditions for which treatment is sought,preexisting conditions, and any medical insurance information.

During a patient's stay in a hospital, written information relating tohis medical history, doctors' and nurses' observations and remarks,laboratory reports, diagnoses, doctors' orders, prescriptions and othernotes by the medical team, including doctors, nurses, technicians,orderlies and the like, become part of the patient's file. Patients withchronic conditions or who are frequently hospitalized may have numerousfiles of substantial size which contain important historic, as well ascurrent, information. The information that is necessary to provide acomplete picture of the patient includes, for example, the patient'svital signs, fluid balance, respiratory function, blood parameters,electrocardiograms, x-rays, CT scans, MRI data, laboratory test results,diagnoses, prognoses, evaluations, admission and discharge notes, andpatient registration information. This information originates from avariety of sources, including the patient, doctors, nurses, monitorsconnected to the patient, testing laboratories, the patient's medicalrecords, and hospital administration records.

A massive amount of information about the patient is therefore generatedin a relatively short time. Increasingly, this information isautomatically recorded or manually entered into a computer-based medicalinformation system. Critical care environments, such as hospitalintensive care units, trauma units, emergency rooms and the like, arefilled with state-of-the-art electronic equipment for monitoring ofpatients. Such systems include a plurality of patient monitoring devicesthat record information related to the patient's status. These systemsmay also capture information about the medical resources being consumed.

Furthermore, many hospitals have changed the way in which patients arebilled for services. In the past, patients were typically billed on thebasis of days hospitalized. With recent changes in health caremanagement and practice, patients are now more likely to be billed onthe basis of treatments received. Greater efficiency in the treatment ofpatients is therefore emphasized. As a consequence, hospitals nowscrutinize the effect of a treatment on a patient more closely, withincreased monitoring, observation and recordation of the patient'sresponses to treatment. The burden of entry of the increased amount ofinformation that must be recorded about a patient has been reduced byincreased automation.

Commonly owned U.S. Pat. No. 6,322,502 B1 entitled Medical InformationSystem provides an example of a system for obtaining data andinformation from and about a patient in a hospital, and making itimmediately and selectively accessible to various members of the medicalteam in a hospital in accordance with the functions performed by thosemembers. This information may be displayed, at least in part, on screenin a flowchart. To date, systems and methods for automated use of suchdata and information in identifying clinic opportunities are notprovided, but could be extremely useful in efficiently identifying setsof individuals as candidates for certain clinic treatments, study groupsor trials. Identification of opportunities to improve patient care andefficiency of resources using automated data would also prove to beextremely beneficial.

SUMMARY OF THE INVENTION

In accordance with the present invention, a system and method areprovided that assist clinicians in their research, analysis, treatment,resource utilization, and quality assurance activities. For instance, asystem in accordance with the present invention may inform clinicians ofpatients that are suitable for clinical trials, or may inform cliniciansor administrators of inefficient use of (or need for) hospitalresources. Such a system utilizes information generated or provided by amedical information system to identify the occurrence of certain“events.” A predefined set of condition statements that identify theoccurrence of events are definable by a user (e.g., clinician) in theform of event detection processes. The occurrence of an event may, forexample, cause an action to be initiated, such as messages to begenerated and transmitted to bedside or remote displays of the medicalinformation system, or to some other system. Detection of some events byone activated event detection process, may cause other event detectionprocesses to be triggered or monitored for triggering. In one context,identification of clinical trial candidates may be performed bymonitoring patients using the medical information system to gather data(e.g., “patient data”). Patient data is useful in determining whether anevent has occurred. As one example, it enables an event detectionprocess to flag a patient as a clinical trial candidate. At least someof the patient data is dynamically generated data from patientmonitoring processes. The evaluation of the patient data may beperformed in real-time, later off-line, or some combination thereof.

A typical medical information system in a clinic, hospital, or othermedical facility may be a networked computer system that collects,stores, analyzes and manages a variety of types of patient data.Relatively static patient data, such as prior or current medicalconditions, diagnosis, prognosis, statistics, and so on for one or morestays may also be maintained in the medical information system for agiven patient. An account management system may be included as part ofthe medical information system, or it may be interfaced with the medicalinformation system. The account management system typically storespatient account information, including patient name, address, telephonenumber, insurance information, billing and payment information, and thelike.

Beyond relatively static patient data, dynamically changing patient datamay also be collected and stored. Accordingly, monitoring processes anddevices collect real-time or near real-time patient data during apatient's stay. Examples of dynamically changing patient data that maybe monitored include a patient's heart rate, temperature, bloodpressure, respiration rate, electrical brain activity, chemical balanceor composition. These types of patient data are referred to asparameters. Many other types of patient data (or parameters) known inthe art may also be collected or monitored. Monitoring is typicallyaccomplished, to some degree, using bedside units (BSU's), which aredevices included in or configured to interface with the medicalinformation system and posted proximate to the patient. BSU's mayinclude output devices such as display screens, printers, audiblealarms, communication ports or some combination thereof, and inputdevices such as keypads, keyboards, input ports, probes, sensors,cameras, recorders or interfaces to other data sources.

In accordance with the present invention, an event management system isintegral with or interfaced to the medical information system, whichtypically includes various patient monitoring systems and devices. Themonitoring systems and devices provide inputs to the event managementsystems for determining whether or not events have occurred and eventdetection processes are to be triggered. The event management system mayinclude, or may be configured for access by, any of a variety ofdevices, such as a desktop computer, workstation, laptop, personaldigital assistant (PDA), telephone, server, or other network enableddevice or programs, modules or components of such devices.

Using the event management system, event detection processes are definedby constructing a user (e.g., clinician) defined algorithm that utilizespatient data. The algorithm is comprised of a set of statements whichdefine parameter-based tests or conditions to be met. As an example, astatement may be defined as “if temperature >100 degrees, then . . . ”.Depending on the algorithm embodied in an activated event detectionprocess, processing of patient data according to one or more eventstatements may cause any of several responses. That is, responses to thedetection of an event may include such actions as message generation andtransmission, or some other action being initiated, maintained orterminated. Messages may be sent selectively to a subset ofworkstations, or other devices, or may be broadcast to all workstationsor devices. That is, messages may be selectively targeted to certainsets or subsets of users, classes of users, or devices. After an eventis detected, the event detection process may or may not continue to beactive and another event detection process (i.e., a secondary eventdetection process) may be triggered, in response to detection by thefirst event detection process.

The event management system may include an event manager module, havinglogic and instructions necessary for establishing a graphical userinterface for user devices (e.g., a desktop computer, workstation, PDA,and so on), generating event detection process algorithms andstatements, defining events and event parameters, processing inputs andoutputs, and interfacing with other relevant devices and programs (e.g.,operating systems, desktop applications, and so on). The event managermodule may be distributed across various devices, e.g., arranged in aclient-server architecture, or implemented in other manners known in theart. Preferably, the event management system generates a user interfacein a Web browser context and implements commonly available and known Webbrowser features, such as radio buttons, toolbars, drop down lists,menus, text entry fields, graphical linking and so on.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawing figures depict preferred embodiments by way of example, notby way of limitations. In the figures, like reference numerals refer tothe same or similar elements. Algorithms are defined according to one ormore desired events.

FIG. 1 is a diagram of a system architecture including an eventmanagement system in accordance with the present invention.

FIG. 2A-2B are event flow diagrams implemented by the event managementsystem of FIG. 1.

FIG. 3 is a top level event management system screen rendered on aworkstation by the event management system of FIG. 1.

FIGS. 4A and 4B are a exemplary statement customization shots ofscreens, windows and forms rendered on a workstation by the eventmanagement system of FIG. 1.

FIG. 5A-5D are exemplary event customization shots of screens, windowsand forms rendered on a workstation by the event management system ofFIG. 1.

FIG. 6A-6C are exemplary event testing shots of screens, windows andforms rendered on a workstation by the event management system of FIG.1.

FIG. 7 is a shot of an event log rendered on a workstation by the eventmanagement system of FIG. 1.

FIG. 8A-8F are exemplary event manager shots of screens, windows andforms rendered on a workstation by the event management system of FIG.1.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A system and method in accordance with the present invention provides ameans for the detection of one or more events as a function, at least inpart, of information and data gathered from monitoring one or morepatients. In response to the detection of an event certain actions maybe taken. Event detection processes can be defined and then triggered todetect the occurrence of any of a variety of conditions. For instance,for a given clinical trial, events can be defined that indicate that acertain patient (or patients) would make a suitable candidate for thatclinical trial, i.e., the patient meets necessary or desired criteria.In other cases, events can be defined that indicate that the patient isa candidate for or in need of a certain type of treatment. In yet othercases, events can be defined that indicate that hospital resources arebeing utilized in a certain manner. That is, such events may relate tothe efficiency or inefficiency in use of certain resources, or suchevents may concern usage under certain circumstances. Such resources mayinclude availability or usage of equipment, inventories, and so on. Anactivated event detection process determines the occurrence of suchevents.

In the preferred form, an event management system is used in conjunctionwith a medical information system, such as described in U.S. Pat. No.6,322,502 B1. The medical information system may include or be used inconjunction with a clinical system that is used for administeringclinical trials. In the preferred form, the medical information systemincludes bedside devices and systems (collectively “bedside units”(BSUs)) for patient monitoring and care. The medical information systemprovides a means for monitoring patients and collecting, storing, andmaintaining patient data. Patient data may include a combination ofrelatively static and dynamically changing information related to apatient. Relatively static patient data may include the patient's name,address, and insurance information, as well information regarding thepatient's medical history and prior care, diagnosis, prognosis,treatment and related information. Dynamically changing patient data mayinclude a patient's heart rate, temperature, blood pressure, respirationrate, electrical brain activity, and chemical balance or composition, orother typically measured parameters.

The present invention may be implemented within the architecturedepicted in FIG. 1, as one possible embodiment. In this embodiment, amedical information system 110 comprises several workstations connectedto a set of servers (not shown) via a network 115. The workstations andservers may be local, remote, or some combination thereof to each other.The medical information system 110 serves as the collector andmaintainer of patient data, in a database system 112. The medicalinformation system 110 is coupled to or includes a plurality of BSUs 140that monitor patient status and collect patient data. In the preferredform, the BSUs also couple to network 115. Network 115 is depicted as alocal area network (LAN) for simplicity. However, the present inventionis not limited in this manner. Network 115 may by a LAN, wide areanetwork (WAN), virtual private network (VPN), the Internet, World WideWeb or some combination thereof.

FIG. 1 shows an event management system 120 in accordance with thepresent invention, linked to medical information system 110 via network115. There may additionally, or alternatively, be provided a wirelessnetwork link 135 between event management system 120 and medicalinformation system 110. The event management system 120 may include itsown database system 122 for storing information and data related to theevents (e.g., event and statement definitions, algorithms, clinicaltrial treatment or resource information and data) as well as patientdata. In other embodiments, the event management system 120 may behosted on the same servers, workstations and computers as the medicalinformation system 110 and may share at least a portion of database 112.Event management system 120 and medical information system 110 mayaccess, or may be accessed by, one or more remote systems 130, withtheir own database systems 132, for data access, exchange, ormaintenance. For example, such remote systems 130 may include wired orwireless computers, servers, cellular telephones, pagers, personaldigital assistants, e-mail devices, or other network, Web or Internetenabled systems or devices.

In the preferred embodiment, the event management system 120 includes anevent manager 125 that facilitates the creation of event detectionprocesses and statements using a scripting language, e.g., VB Script,although other programming languages may be used. In the preferredembodiment, a statement is a VB Script function that is similar to aformula for determining the value of a given parameter or set ofparameters (weighted or otherwise). A statement can call for patientdata and calculate and output a parameter's value. The event manager 125receives the outputs from statements included in the event detectionprocess. Each executed statement returns a value, e.g., a true or falsevalue, or initiates, terminates or maintains an action.

The example of FIG. 2A illustrates a typical event 200, e.g., forinclusion in a shock study. When the variables defined in block 202 areall fulfilled simultaneously, the event management system 120 generatesa message, indicated in block 204. In this case, the event 200 hasoccurred if a particular patient is determined to be suitable forinclusion in a study about shock. The heart rate, blood pressure, andrespiration rate information may be provided by the medical informationsystem 110 and BSUs 140.

The diagram 250 of FIG. 2B offers a conceptual representation of theprocessing for determination of an event. In the preferred form, everyevent determination is based on the results of execution of one or morestatements. In this example, the event includes three statements,statement A 252, statement B 254, and statement C 256. Each statementreturns a numeric value into the event and the event sums all statementvalues. This sum is compared, in decision block 260, to predefinedactivation values for this event. Whenever the event value is higherthan its activation value, the event has occurred or is “turned on”, instep 270. When an event is detected, one or more of three actions may betaken: (1) a message may be sent, in step 272; (2) the event process mayor may not continue to be active, in step 274; and (3) another,secondary event detection process may begin, in step 276. If the eventis not detected, it continues to check the patient data, in step 274. Instep 278, a request for validation may also be performed, wherein theuser responds to or confirms the detection. For example, referring toFIG. 2A, the statement HR>120 bpm may return the value 1 when the heartrate is greater than 120 and return the value 0 when the heart rate islower than 120.

The event manager 125 can assist clinicians in their research andquality assurance activities. An event manager graphical user interfaceprovides users with a mechanism to define and create their own eventalgorithms and messages. In the preferred form, the event manager 125runs on data from the medical information system database 112 and may beconfigured to operate with a time delay to enable larger amounts of datato be stored before event statement processing. When sending messages,the event manager 125 can be customized to send a message to allworkstations of the event management system 120 or medical informationsystem 110. The event manager 125 can send messages to devices (e.g.,displays) within the medical information system or beyond, such that adevice displaying a flowsheet for one patient could have a pop-up windowrendered with a message that is not related to that flowsheet orpatient.

I. Customizing with the Event Manager

Before event detection processes can be triggered in a medicalinformation system 110, events must be created and customized to theneeds and requirements of the clinical environment. Using the eventmanager 125, the event creation and customization process involves twomain elements: creating (or customizing) statements and creating (orcustomizing) events. The same statement may be used in numerous events.

Event Manager Customization Screen

In the preferred form, events are created and customized using an eventmanager customization screen 300, shown in FIG. 3. The event managercustomization screen 300 comprises an icon toolbar 302, which includesicons for creating, saving, deleting, testing, and filtering statementsand events. The screen includes two panes, a statements and events pane310 and a customization pane 320. Statements and events pane 310includes a statements and event tree 312. The statements portion of tree312 includes all customized statements, divided into categories. Theevents portion of tree 312 includes all customized event detectionprocess divided into categories. The customization pane 320 is contextsensitive and contains different functionality depending upon theelement that is then being customized, namely, the statement or eventdetection process.

The icons in the icon toolbar 302 are context sensitive; that is, theyperform different actions depending on the element being customized. TheNew icon facilitates creation of a new statement or event detectionprocess, depending on whether Statement or Event is highlighted in thestatements and event tree 312. The Save icon saves the newly customizedstatement or event detection process. The Delete icon deletes the eventdetection process or statement highlighted in the statements and eventtree 312. The Test icon facilitates testing of event detection processesusing prior data. Finally, the Filter icon facilitates the display ofspecific user selected statements and event detection processes.

Customizing Statements

At a top level, to customize a statement, a user may (1) open a newstatement form; (2) enter a category, name, and abbreviation; (3) entera logical script in the composition pane; (4) select a type of return;(5) add result values; (6) check syntax; and (7) save the statement. Inthe preferred form, a statement is a parameter so the statement and itsresults may be represented in a flowsheet rendered on a medicalinformation system 110 display. In this case, the flowsheet celldisplays the resultant value of the statement, whether the eventdetection process including the statement was activated or not.

At a more detailed level, statements may be built step-by-step. FIG. 4Ashows a statement form (or screen) enabled from the event managercustomization screen 300 shown in FIG. 3. A new statement may be createdaccording to the following steps:

Step 1: In this step, the user opens a new (or customize) statement form420 as follows:

1. Highlight Statements in statements and events tree 312 of screen 300.

2. Select New from the icon toolbar 302 and the statement form 420appears in place of the customization pane 320.

3. The statement form 420 includes two tabs, which cover all stages ofstatement customization. A Script tab 422 is used for building astatement. A Used by tab 424 includes a list of all the event detectionprocesses that use a selected statement. The Used by tab 424 includesdata only after the statement has been used in an event detectionprocess.

Step 2: In the second step, the user enters a category, name andabbreviation. Every statement belongs to a category, and the category isdefined by a name and abbreviation. In the preferred embodiment, thestatement form 420 includes a category dropdown list 426 to acceptselection of a predetermined category for association with a statement.This category dropdown list 426 includes all relevant parametercategories. From the category dropdown list 426, a category may beselected. To identify the new statement, a statement name andabbreviation are entered into the relevant fields.

Step 3: In the third step, the user enters a script in compositionwindow 430. In the preferred form, the composition window 430 is a VBScript editing window. The composition window 430 supports a high degreeof functionality, such as “if/then” statements and variable definitions.For sophisticated calculations, a user may use formula parameters fromits own database. In the preferred form, different script term functionsappear in different colors. Delimiters appear in green, functions appearin pink, keywords appear in blue, and operators appear in dark red.Although based on VB Script, the composition window 430 may easily beused without any knowledge of VB Script. The script in the compositionwindow always returns a value, by default; it therefore always includesa function called “Return_Value=”, as is shown.

A simple script may contain only the abbreviation of the parameter to beused in the statement, for example “Return_Value=(“HR”)”. This scriptwill return the current heart rate value of a patient: The parameterabbreviations may be inserted into the composition window 430 using anInsert parameter function, shown in FIG. 4B. To accomplish this, aright-click action within the composition window 430 causes an Insertparameter option button 470 to be rendered. Selection of this optionbutton 470 opens an Insert parameter form 480. The desired parameter foruse in the statement can be selected from the Insert parameter form 480.Upon selection, the parameter abbreviation is automatically insertedinto the composition window 430. Select Close and the Insert parameterform 480 closes. Also note, formula syntaxes may be entered into thecomposition window 430.

Step 4: In this step, the user selects the type of return, from thereturn options 440 of FIG. 4A. Each statement returns a result. Theresult for a given statement is used in any event detection process towhich the statement is assigned. In the preferred form, this result maybe one of three types:

Boolean—Returns either true or false. For example, if the heart rate isgreater than 120, returns true, else returns false.

Value—Returns a predefined value for each result returned from thescript. For example, if the systolic blood pressure is lower than 90,return 10, if it is between 90 and 120, return 5, and if it is greaterthan 120, return 7.

Actual value—Returns the actual result returned from the script. Forexample, if the systolic blood pressure is 90, the return result is 90.

To choose a type of return, select the appropriate radio button besidethe set of return options 440. When box 442 of Show only if complete ischecked, the statement will return a result value only if all thecomponents of the statement exist. Otherwise, no result value will bereturned.

Step 5: In this step, the user adds or defines result values. Newstatement form 420 includes mechanisms 450 to define a new result value.Selecting the Add button causes a window to open that allows selectionand input of an operand. Options for editing and deleting a return valueare also provided. In the preferred form, an operand dropdown list ispresented from which the user can select the required operand. Thedropdown list includes the following operands: >, ≧, <, ≦, =, < >. Oncethe operand is selected, the user can enter a value to which the operandrefers in a provided value field, for example, >100. The user can thenselect the return value, as discussed above.

If working with a Boolean type of return, the returns field will containa dropdown list with the options True or False. If choosing to return avalue from a predetermined set of values, a required return value willneed to be entered into a return field. If choosing to return an actualvalue, there is no need to define operands and return values.

Step 6: Before completion, the user can check the validity of the syntaxof the new script. To do so, the user selects the Check statement syntaxbutton 460. If the script contains any syntax errors, a message will bereturned indicating the location of the error (e.g., row+column),facilitating correction of the error.

Step 7: The statement can be saved by selecting the Save icon fromtoolbar 302.

The above steps may be further appreciated by continuing the previousExample 1 of FIG. 2A. In creating an event to assess suitability forinclusion in a shock study, create statements for HR>120 bpm, systolicBP 90 mmHg, and respiration rate >20/m. Using screen 400, select Eventmanager category. Name the statement “ShockStudy_HR” and give it theabbreviation “ShockStudy_HR”. In the composition window 430 enter“Return_Value=(“HR”)”. Select the Boolean type of return and select theShow only if complete option 442. Select the operand and enter the value120. Select the True option in the returns dropdown list (not shown) andsave the statement for HR 120 bpm. This procedure can be repeated tocreate statements for systolic blood pressure and respiration rate.

Customizing Events

At a top level, to customize an event: (1) open a new event form; (2)define an event detection process; (3) define action options; (4) set anevent detection process schedule; and (5) save the new event detectionprocess. Note that an event detection process may be represented as aparameter in a flowsheet. In this case, the flowsheet cell will displaythe result value of the event detection process, whether activated ornot.

At a more detailed level, event detection processes may be builtstep-by-step. FIG. 5A shows a new event form (or screen) enabled fromthe event manager customization screen 200, shown in FIG. 3. A new eventdetection process may be created according to the following steps:

Step 1: In this step, the user opens new event form 520 as follows:

1. In the statements and events tree 312 highlight Events.

2. In icon toolbar 302, click the New icon and the new (or customize)event form 520 appears in place of the customization pane 320. The eventform 520 contains three tabs, which cover all aspects of eventcustomization. An Event manager tab 522 is used for building the eventdetection process from component statements. An Action tab 524 is usedto customize functions related to activation of the event detectionprocess. A Schedule tab 526 is used to define when, how often, and forhow long the event detection process will run.

Step 2: In this step, the event detection process is defined. Thestatements used to define an event are selected through the Eventmanager tab 522. To define an event detection process, the user entersthe category, name and abbreviation in the customization pane 520fields. Like other parameters, every event detection process belongs toa parameter category, and has a name and abbreviation. The category andbe chosen from a Category dropdown list. This dropdown list includes allparameter categories. Select the Add button within event form 520 and anAdd new statement window 550 opens (shown in FIG. 5B).

From the Add new statement window 550, a statement category can beselected from the Category dropdown list presented in this window. Froma Statement name dropdown list statements can be selected. If the typeof return is Boolean, the values the statement should return for true orfalse results can be entered, for example, 1 for true and 0 for false.If the type of return is not Boolean, these areas will not appear.Select an action to be performed when an error condition exists from anOn error action dropdown list. For example, such errors may be divisionby zero, not all the required values exist, and so forth. The On erroraction dropdown list offers two options: return value and stop process.In the return value option, once an error is identified, the statementreturns a predefined value. In the stop process option, the eventdetection process is terminated when an error is identified in thestatement. If the return value option was selected in the previousfield, the error value can be entered.

Returning to the event form 520 of FIG. 5A, an Event activation area 530is provided for entry of event detection process activation values. TheEvent activation area 530 is used to define the conditions under whichthe event detection process will be activated. Every statement returns avalue to the event detection process. The values of all the statementsassigned to the event detection process are added together to create theevent detection value (or test condition). This value is compared to thereference values that were defined in the Event activation area 530. Ifthe value of the event detection process is lower or higher, dependingon the definition of the event detection process, then the limits thatwere set, the event has been detected. The event detection processresults may be presented as a parameter within a flowsheet.

The above steps may be further appreciated by continuing the previousExample 1 of FIG. 2A. Wherein, after creating the statements requiredfor the shock study event, create the event detection process, add thestatements, and enter the event activation values that will enable theevent detection process. From the Event area 528, select the EventManager category and name the event “ShockStudy” and give it theabbreviation “ShockStudy” (see FIG. 5A). Add the ShockStudy_HR statementby selecting the category Event manager and selecting the name“ShockStudy_HR”. Enter true value=1 and false value=0. Then select an Onerror action dropdown list and select a return value. Enter error value0. Repeat for the other statements required to fully define this event,i.e., systolic blood pressure and respiration rate. Enter event testcondition (e.g., “higher than 2”). In this example, if all threestatements have a value of 1 (i.e., true), then the event has beendetected, since the sum will be three.

Step 3: In this step, the user defines action options. The Action tab524 of event form 520 is used to customize actions in response todetection of an event. FIG. 5C provides an example of an Action window580. Action window 580 is divided into three sections, representingthree types of actions:

Message 582—This section allows creation and transmission control ofevent messages. A message field 583 defines a space for composition of afree text message that will appear when the event is detected. If amessage is not to be sent, the Send message to patients message centercheckbox should not be selected. If a message is to be sent to allpatients, check the Send to all patients check box (shown grayed out).

Activation 584—By default, an event detection process will run accordingto the predefined schedule after being triggered. The Activation section584 allows a user to define a period of time during which the eventdetection process will not run again after activation. In addition, auser may define that an event detection process will run only once afterbeing triggered. To make these selections, activation of the Repeat onlyafter button and Trigger only once button are activated (shown grayedout).

Secondary event 586—This section allows the definition of secondaryevent detection processes. A secondary event detection process is aprocess that starts when an event upon which it is dependent has beendetected. For example, an event detection process that identifies lowblood pressure may start another event detection process that identifieshigh heart rate. To select a secondary event detection process: (1)select the Events list button; an Events list window opens (not shown);(2) a category can be selected from a Category dropdown list; and (3)the required event detection process can be selected from a presentedEvents list. The secondary event detection process can be set to beginat a defined time after the first event is detected. This time periodcan be defined in minutes or hours. It is set in the Delay fieldsassociated with the Secondary event field.

Continuing with Example 1, from Action window 580 a user can defineaction options for the Shock Study event, by creating a message to besent to the patient message center once only. The text “This patient maybe suitable for inclusion in shock study” may be entered into theMessage field 582. The Send message to patients message center check boxshould be selected from Message section 582. As an example, selectTrigger only once option.

Step 4: In this step, the user can set an event detection processschedule. From event form 520, the Schedule tab 526 is selected.Selection of the Schedule tab 526 causes a Schedule window 590 to berendered, shown in FIG. 5D. The Schedule window 590 is used for definingwhen and for how long the event detection process will run. The Schedulewindow 590 includes the following sections:

Duration 592—This section of Schedule window 590 provides mechanisms toset specific dates on which the event detection process will run.

Start time 594—This section includes three options: (1) No start time,wherein the event detection process begins to run as soon as it isassigned; (2) Start at, wherein the event detection process begins torun at a predetermined time; and (3) Start [ ] hours after admission,wherein the event detection process begins to run at some user inputnumber of hours after the patient was admitted.

End time 596—This section includes the same functionality as the Starttime 594 segment.

Frequency-Interval 598—This section provides mechanisms to set thefrequency at which the event detection process will run. For example, ifthe user sets the Frequency field to 1 hour, the event detection processwill look for values every hour. An event detection process that runs ata frequency of one minute will cause a much greater load on the systemthan an event detection process that runs at a frequency of one hour.Many events with a frequency of one minute running simultaneously mayunacceptably slow the system, in some implementations.

The Frequency-Interval portion 598 section also provides mechanisms toset the time interval that will be checked every time the eventdetection process runs. For example, if a user sets the Interval fieldto 1 hour, every time the event detection process runs it will run onthe data from the previous hour. Note, in the preferred form, the eventmanager 125 will always start looking for data in the first minute ofthe defined interval and will then continue checking forward. This meansthat the data used is not necessarily the most recent data available inthe database. The frequency and interval should be selected according tothe parameters defined in the event detection process and consideringthe way it will affect system performance.

An event detection process that is based on parameters that are receivedevery minute, such as heart rate, may be set with a frequency of 1minute. An event detection process that is based on, for example, labdata and order parameters may be set with a lower frequency, and at aninterval that covers the time gaps: e.g., a frequency of 30 minutes andinterval of 30 minutes. The Interval value should be selected accordingto the intervals on which the data is usually entered into the system.For instance, if lab data enters the system at a maximum frequency ofevery hour, the user may set a frequency and an interval at 1 hour. Notethat if the interval is lower than the frequency, some of the data willnot be searched for events. For example, if the frequency is set to 1hour with an interval of 30 minutes, only 30 minutes of each hour willbe searched by the event manager 125.

Continuing Example 1, to set an event detection process schedule usingSchedule window 590, the user may select start and end times, frequency,and interval for the event detection process, so that the eventdetection process starts running immediately. To do so, the user selectsNo start time and No end time. A frequency of 1 minute is set. And, aninterval of 2 minutes is set. This overlap is necessary because a valuemay be missing in a specific minute, or there may be a differencebetween the time the event is checked and the time the signal enters thesystem.

Step 5: In this step the event detection process is saved. Referring toFIG. 5A, to save the customized event detection process, the Save iconin icon toolbar 302 is selected. Once the event detection process iscustomized, it is displayed in the Used by tab 424 (see FIG. 4A) inassociation with the corresponding statement. A statement or eventdetection process that is in use in another event detection process maynot be deleted.

Testing Events

Preferably, the event management system 120 includes mechanisms to testevent detection processes and statements, other than those syntaxrelated mechanisms discussed earlier. In the preferred form, thecustomization form enables a user to test an event detection processwith existing data. Such tests help the user to estimate how often andunder what circumstances the created event detection processes will beactivated. This option is also available via the event manager module125, discussed in greater detail below.

To perform a test, referring to FIG. 4A, an event detection process tobe tested is selected from the statements and events tree 312. The Testicon from icon toolbar 302 is then selected, causing an Event testwindow 600 to open, see FIG. 6A. Required dates and times for the testare entered into the Test period section 602 of Event test window 600.Required frequency and interval are also entered in the Checking section604. These fields have the same functions as the Frequency and Intervalfields in the previously discussed Schedule window 590. A patient to beused in performance of the test is highlighted from a Patients list 612within an Assigned patients pane 610. Highlighted patients are enteredinto a Selected patients list 614 using a selection arrow. A user cantest the event detection process on all patients, by using thedouble-arrow button to move all patients to the Selected patients list614. To initiate the test, select the Test button 616 and a Test resultswindow 630 opens, see FIG. 6B. The duration of the test depends on thecomplexity of the event detection process, the defined time frame forthe test, the selected frequency and the number of patients.

Once the test is complete, test results can be copied into anotherapplication (e.g. Microsoft Word™ or Excel™) for further analysis. Tocopy test results, the Copy button 632 of Test results screen 630 isselected. In the preferred form, this causes a Copy Options window 650(see FIG. 6C) to open offering copying options, including: Copy testresults list 652 or Copy test results details 654. The user selects theradio button of the preferred option. Results can be copied ‘as is’, orwith the details of the event for each result. Selection of the OKbutton 656 pastes the results into the required application.

II. Using the Event Manager

The event manager 125 is the module that enables the user to manageexisting event detection processes and view the details of events thatwere detected. Unlike other modules, the event manager 125 is not onlyrelated to the current patient, but can present data for all patients atany time and at any BSU. Therefore, an event message relating to onepatient may be presented (or pop-up) on a display, while that display ispresenting the data or flowsheet of another patient. If this is thecase, the event message will preferably observe a format similar to thatshown in an event manager log window 700 of FIG. 7. Note, the eventmanager log window 700 of FIG. 7 includes the phrase “This is not thecurrent patient” warning at the bottom of the message pop-up dialog box,indicating that the test message relates to a patient not represented inthe flowsheet.

FIG. 8A shows an event manager screen 800, in accordance with thepresent invention. The event manager screen 800 included the followingelements:

Icon toolbar 802—The icon toolbar 802 facilitates access to frequentlyused event manager functionality. These icons are context sensitive, soare selectively enabled given the user's interactions with the variousmechanisms and areas of the screen. For example, the Save button savesassignments for patients and for event detection processes.

Patients and Events Tree 812—The patients and events tree 812 includesthree parts: Patients, Assigned events, and Events. The Patients portionof the tree includes two lists, i.e., Active patients and Non-activepatients. The Assigned events portion includes all event detectionprocesses that are currently assigned to patients, divided intocategories. The Events portion includes all customized event detectionprocesses, divided into categories.

Monitoring 822—The Monitoring tab 822 causes a monitoring window to berendered that includes a list of event detection processes that havebeen activated, corresponding to the highlighted option in the Patientsand Events tree 812 and a defined timeframe.

Assignment 824—The Assignment tab 824 causes a window to be renderedthat is used for assigning event detection processes to patients andbeds. The content of this window changes according to the highlightedoption in the patients and events tree 812.

As an example, selection of the Monitoring tab 822 causes a monitoringwindow 830 to be rendered (see FIG. 8B). The monitoring window 830includes a list of activated event detection processes 832,corresponding to the highlighted option in the patients and events tree812, and a defined timeframe. The list of event detection processeschanges according to the highlighted option in the patients and eventstree 812. For example, if a patient name is highlighted, the list willshow the event detection process activated for that patient at thespecific timeframe. If an event detection process is highlighted, thelist will show the activation times for the event detection process inthe specific timeframe, for all patients. The timeframe for the eventdetection process list 832 is provided for in the Activation timesection 826 of the event manager window 800. In the preferred form, thedefault time frame is the last 24 hours.

The Event log details button 834 of the monitoring window 830 opens awindow (not shown) with activation details of the event detectionprocess highlighted in the event detection process list 832. Thesedetails refer to a specific activation for an event detection process orfor a given patient. The Assigned event details button 836 of themonitoring window 830 causes a window to be opened with activationdetails of the event detection process highlighted in the eventdetection process list 832. These details refer to general details ofthe event detection process.

Selection of the Assignment tab 824 causes a context sensitiveassignment window 850 (sec FIG. 8C) to be rendered. That is, theavailable functions change according to the highlighted option in thepatients and events tree 812. If a patient is highlighted, theassignment tab includes an Events list 852 and an Assigned events list854. Using assignment window 850, an event detection process can beassigned to a patient as follows:

1. Highlight the required event in the Events list 852.

2. Select the arrow “>” and the event moves to the Assigned events list854.

3. Select the Save icon in the event manager screen 800 icon toolbar 802(see FIG. 8A).

If an event detection process highlighted, the assignment window 850 istransformed to the Assignment window 860 of FIG. 8D to include aPatients list 862 and a Beds list 864. Assigning a patient or a bed toan event detection process is done in the same manner as assigning anevent detection process to a patient, previously discussed, i.e., byselecting from the list and actuating the corresponding arrow button.When an event detection process is assigned to a bed, it will run on allpatients that are admitted to that bed.

Assignment window 860 also allows a user to assign an event detectionprocess to all patients, by selecting the All patients button 866. TheAssigned event details buttons 868, associated with the assignedpatients and assigned beds, are used for setting the event for theassignment. Actuation of the Assigned event details button 868 opens anassigned event details form 870 (see FIG. 8E), similar to the new eventform 520 of FIG. 5A. The assigned event details form 870 includesdefault values assigned to the event during the customization process.The user can change these default values for the specific assignment.For instance, the user may change the frequency for a specificassignment, if assigning the event detection process to a large numberof patients, in order to avoid unwanted slowdown effects on systemperformance. The Event manager tab 872 of the assigned event detailsform 870 may include an Enabled check box (not shown), which indicatesthat an assignment may be marked as non-active, but kept for future use.When the set of defined conditions is met, an event manager messagewindow 880 pops up on the user's screen, such as that of FIG. 8F.

Using the event manager message window 880, a user can enter a commentin the Comments area 882 before validating the message. To seeadditional information regarding the event detection process, the userselects the Details button 884. The Details button 884 opens a detailssection (not shown) of the message window 880. In order to close theevent manager message window 880, the Validate button 886 is selected.Like other validation actions in the preferred embodiment of the eventmanager 125, this action is registered under the name of the user whoperformed it.

While the foregoing has described what are considered to be the bestmode and/or other preferred embodiments, it is understood that variousmodifications may be made therein and that the invention or inventionsmay be implemented in various forms and embodiments, and that they maybe applied in numerous applications, only some of which have beendescribed herein. As used herein, the terms “includes” and “including”mean without limitation. It is intended by the following claims to claimany and all modifications and variations that fall within the true scopeof the inventive concepts.

1. An event management system, configured to access or obtain patientdata from a medical information system comprising a set of electronicdevices including means for monitoring patients, wherein said eventmanagement system comprises: A. an event manager is hosted, at least inpart, on a set of electronic devices having output devices and inputdevices, said event manager comprising: 1) a statement customizer fordefining one or more statements, each of said statements configured totest at least one criterion; 2) an event customizer, including means fordefining an event detection process and associating a set of saidstatements with said event detection process, and means for defining anevent test condition and at least one event action; 3) an analyzer,configured to apply said set of statements to said patient data and todetermine satisfaction of said test condition, as a function ofsatisfaction of one or more criterion of said set of statements; and 4)an activator, configured to initiate said at least one event action inresponse to said satisfaction of said test condition.
 2. The system ofclaim 1, wherein said at least one event action is the generation of atext message configured for presentation on a display of said eventmanagement system.
 3. The system of claim 1, wherein said at least oneevent action is the generation of a text message configured forpresentation on a display of said medical information system.
 4. Thesystem of claim 1, wherein at least some of said set of event electronicdevices and said medical information system set of electronic devicesare electronic devices shared by the event management system and themedical information system.
 5. The system of claim 1, wherein said eventmanagement system is accessible by a wireless device.
 6. The system ofclaim 1, wherein said event management system is configured to couple tosaid medical information system via a LAN, WAN, virtual network, privatenetwork, the world wide web, the Internet, a telephone network, or somecombination thereof.
 7. The system of claim 1, wherein said eventcustomizer is configured to associate each statement from said one ormore statements with more than one event detection process.
 8. Thesystem of claim 1, further comprising: 5) an event detection processtester, configured to execute said event detection process using priorpatient data.
 9. The system of claim 1, wherein said at least onecriterion is associated with candidacy requirements for inclusion of apatient in a clinical trial and said event action includes anidentification of one or more candidate patients for said clinicaltrial.
 10. The system of claim 1, wherein said at least one criterion isassociated with a medical condition of a patient and said event actionincludes an identification of a treatment for said medical condition.11. The system of claim 1, wherein said at least one criterion isassociated with use of one or more medical information system resourcesand said event action includes an identification of one or moreinefficiently used resources.
 12. The system of claim 1, wherein said atleast one event action is transmission of a signal configured toterminate a monitoring process by said medical information system. 13.The system of claim 1, wherein said at least one event action istransmission of a signal configured to begin a monitoring process bysaid medical information system.
 14. The system of claim 1, wherein saidevent customizer includes means to associate a secondary event detectionprocess with said event detection process, wherein said secondary eventdetection process is chosen from a set of previously defined eventdetection processes.
 15. The system of claim 1, wherein said eventmanager further includes means to set an event detection processfrequency and interval for selectively enabling said analyzer.
 16. Anevent management system, comprising: A. a communications network; B. aplurality of patient monitoring devices coupled to said network,including means for providing dynamically changing patient data; C. aset of electronic devices coupled to said network and having outputmeans and input means; and D. an event manager, hosted on said set ofelectronic devices, said event manager comprising: 1) a statementcustomizer for defining one or more statements, each of said statementsconfigured for testing at least one criterion; 2) an event customizer,including means for defining an event detection process and associatinga set of said statements with said event detection process, and meansfor defining an event test condition and at least one event action; 3)an analyzer, configured to apply said set of statements to said patientdata and to determine satisfaction of said event test condition, as afunction of satisfaction of one or more criterion of said set ofstatements; and 4) an activator configured to initiate said at least oneevent action in response to said satisfaction of said test condition.17. The system of claim 16, wherein said event management system isconfigured for access by a wireless device.
 18. The system of claim 16,wherein said network includes a LAN, WAN, virtual network, privatenetwork, the world wide web, the Internet, a telephone network, or somecombination thereof.
 19. A method of establishing event management foruse in conjunction with a medical information system, wherein saidmedical information system is configured for monitoring a plurality ofpatients and providing dynamically changing patient data, said methodcomprising: A. interacting with said medical information system,including receiving said patient data; B. defining one or morestatements, each of said statements configured for testing at least onecriterion; C. defining an event detection process, including associatinga set of said statements with said event detection process, and definingan event test condition and at least one event action; D. establishingan analyzer configured for applying said set of statements to receivedpatient data and for determining satisfaction of said event testcondition, as a function of satisfaction of one or more criterion ofsaid set of statements; and E. establishing an activator for initiatingsaid at least one event action in response to said satisfaction of saidevent test condition.
 20. The method of claim 19, wherein said at leastone event action includes generating a text message configured forpresentation on a display of said event management system.
 21. Themethod of claim 19, wherein said at least one event action includesgenerating a text message configured for presentation on a display ofsaid medical information system.
 22. The method of claim 19, wherein atleast some of said set of event electronic devices and said medicalinformation system set of electronic devices are electronic devicesshared by the event management system and the medical informationsystem.
 23. The method of claim 19, wherein said interacting includescoupling to said medical information system via a LAN, WAN, virtualnetwork, private network, the world wide web, the Internet, a telephonenetwork, or some combination thereof.
 24. The method of claim 19,wherein said each statement from said one or more statements can beassociate with more than one event detection process of a plurality ofdefined event detection processes.
 25. The method of claim 19, furthercomprising testing the event detection process by executing said eventdetection process using prior patient data.
 26. The method of claim 19,wherein said at least one criterion is associated with candidacyrequirements for inclusion of a patient in a clinical trial and said atleast one event action includes an identifying one or more candidatepatients for said clinical trial.
 27. The method of claim 19, whereinsaid at least one criterion is associated with a medical condition of apatient and said at least one event action includes an identifying atreatment for said medical condition.
 28. The method of claim 19,wherein said at least one criterion is associated with use of one ormore medical information system resources and said at least one eventaction includes an identifying one or more inefficiently used resources.29. The method of claim 19, wherein said at least one event actionincludes transmitting a signal configured to terminate or initiate amonitoring process by said medical information system.
 30. The method ofclaim 19, wherein said defining an event detection process furtherincludes associating a secondary event detection process with saidevent, wherein said secondary event detection process is chosen from aset of previously defined event detection processes.
 31. The method ofclaim 19, further comprising setting an event detection processfrequency and interval for selectively enabling said analyzer.
 32. Amethod of providing event management, on a computer-based systemcomprised of a plurality of networked electronic devices, said methodcomprising: A. monitoring a plurality of patients and obtaining patientdata, including dynamically changing patient data; B. defining one ormore statements, each of said statements configured for testing at leastone criterion; C. defining an event detection process, includingassociating a set of said statements with said event detection process,and defining an event test condition and at least one event action; D.establishing an analyzer configured for applying said set of statementsto received patient data and for determining satisfaction of said eventtest condition, as a function of satisfaction of one or more criterionof said set of statements; E. establishing, an activator for initiatingsaid at least one event action in response to said satisfaction of saidevent test condition; and F. providing an indication of said eventaction at one or more of said electronic devices.
 33. The method ofclaim 32, comprising displaying a message on a display of one or moreelectronic devices representative of said at least one event action.